There are two accepted methods of increasing physical activity as a therapeutic measure to improve glycemic control among GDM mothers as practiced in our institution. One is a standard and structured antenatal exercise program prescribed by physiotherapist. Second is a counseling provided by the obstetrician on improving physical activity at home. Participants are divided into two groups, based on block randomization. In first group, participants receiving standard antenatal exercise protocol will be given a booklet describing the components of this structured exercise program. They will be given a detailed explanation on these exercises by a physiotherapist, along with some demonstration. Participants will be performing these exercises at home. Weights used will be personalized to patients condition. They would maintain a log book which would be scrutinized by the physiotherapist during their subsequent regular check ups. They would be motivated to ensure compliance, during these check ups. In the second group, treating obstetrician would give them a counseling on improvement on their routine physical activity at home and work place, along with some walking. 

All participants will be prescribed Medical Nutrition Therapy (MNT) according to maternal BMI and sugar levels, as per hospital protocol. Participants are given medications to achieve glycemic target if necessary, as deemed necessary by the treating obstetrician.

Periodic blood sugar levels are monitored as part of standard hospital protocol. Perinatal outcome including mode of delivery, ultrasound biometry, AFI, birth weight, neonatal outcome, and perinatal complications are noted down.  

Physical activity of all participants will be assessed based on WHO-GPAQ questionnaire, and quality of life will be assessed based on WHO-QOL BREF questionnaire before starting intervention and after 8 weeks of intervention. Physiotherapeutical intervention will continue till delivery.

Compliance to diet and exercise will be assessed during their regular visits.